Lack of nurse managers in new commissioning groups

Only a third of the new bodies that will commission NHS services have so far earmarked an executive post for a senior nurse, an investigation by Nursing Times suggests.

Clinical commissioning groups will take over from primary care trusts in April. CCGs must have a non-executive nurse on their governing body but are not currently mandated to have a nurse in the team of executives managing the day-to-day running of the organisation.

Nursing Times analysed the organisational structure of 19 of the most developed CCGs. These 19 are in the “first wave” of 35 CCGs currently being assessed by the new NHS Commissioning Board to see if they are ready to take over from PCTs – a process known as “authorisation”.

Just six of the 19 had created an executive post specifically for a chief nurse, lead nurse or director of nursing. As a result, two thirds of “first wave” CCGs look set to start their role without a figurehead for the nursing profession.

Among the six posts identified by Nursing Times are NHS Leicester City CCG’s chief nurse and quality officer, a head of quality and lead nurse in NHS Rotherham CCG, and a lead nurse and senior officer for quality at NHS East Riding of Yorkshire CCG.

Royal College of Nursing head of policy Howard Catton said the RCN was also closely monitoring the situation. He said the college’s initial assessment was “not quite as grim” and suggested overall that around half of the 35 first wave CCGs had an executive nurse in place.

However, he noted that the precise situation was clouded by the appointment of interims in some places and the range of job titles being used. For example, executive posts that included “quality” or “clinical transformation” in the title might be masking the fact that the position was held by a nurse.

Mr Catton said the RCN was looking for “rigorous conditions” to be attached to the CCG authorisation process to ensure there was multi-disciplinary involvement in commissioning.

Former health minister Anne Milton was warned last year by senior nurses that the NHS was “haemorrhaging” nursing leaders from PCTs in the run up to the changeover to CCGs.

PCT Clusters, which were created in 2010 through the merger of small groups of PCTs, were required to have an executive nurse. Although it was never mandatory for individual PCTs to employ a nursing director, the vast majority did so.

Readers' comments
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Solihull CCG has a chief nurse and 4 further experienced and full-time nurses leading the quality agenda. One of our key objectives is to enable our member practice nurses to influence the quality agenda of our CCG